Epidemiology

The Epidemiologic Catchment Area Study did not include AD in its historic survey of patients in the population of five major settings in the United States. Most studies are of smaller or more discrete samples and have the problem of generalization. Andreasen and Wasek (39) reported that 5 per cent of an inpatient and outpatient sample at the university hospital and clinics in Iowa were labelled as having AD. Fabrega et al. (2,9 reported that 2.3 per cent of a sample of patients presenting to a walk-in clinic (diagnostic and evaluation centre) met criteria for AD, with no other diagnoses on Axis I or Axis II; when patients with other Axis I diagnoses (i.e. Axis I and II comorbidities) were included, 20 per cent had the diagnosis of AD. In general hospital inpatient psychiatric consultation populations, AD was diagnosed as 21.5 per cent, 18.5 per cent and 11.5 per cent respectively.(4 41 and 42) D. Schafer (personal communication, 1990) noted that up to 70 per cent of children in the psychiatric setting may be given the diagnosis of AD in a variety of mental health care environments. Faulstich et al. (43) reported the prevalence of DSM-III conduct and AD for adolescent psychiatric inpatients. Andreasen and Wasek,(39) utilizing a chart review, reported that more adolescents than adults experienced acting out and behavioural symptoms, but adults had significantly more depressive symptomatology (87.2 per cent versus 63.8 per cent). Anxiety symptoms were frequent at all ages.

Mezzich and coworkers*1,29 evaluated 64 symptoms currently present in three cohorts: subjects with specific diagnoses, those with AD, and those who were not ill. Vegetative, substance use, and characterological symptoms were greatest in the specific-diagnosis group, intermediate in the AD group, and least in the group with no illness. The symptoms of mood and affect, general appearance, behaviour, disturbance in speech and thought pattern, and cognitive functioning had a similar distribution. The AD group was significantly different from the no-illness group with regard to more 'depressed mood' and 'low self-esteem' ( p £0.0001). The AD and no-illness groups had minimal pathology of thought content and perception. A positive response on the suicide indicators was obtained in 29 per cent of AD compared with 9 per cent of the no-illness group. The three cohorts did not differ on the frequency of Axis III disorders.

How To Win Your War Against Anxiety Disorders

How To Win Your War Against Anxiety Disorders

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